Consistent low readings - to give insulin?

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Tia_24

Member Since 2013
Hi

My 19yr old cat was diagnosed with FD earlier this year in Feb/March and started off with BG readings of around 27-32 on a daily basis! Through changing her diet and giving insulin her BG readings came down to around 5.5 - 8 on a daily basis. The last few weeks her readings have been around 4.5 - 8 daily and so we haven't been giving her the insulin dosage of 2 units that the vet provided. She is consistently low and I'm concerned that giving her the insulin will make her hypo but I wondered if not giving the insulin could also have a detrimental effect - can anyone give me some advice please?

Thanks

Maria
 
Hi Maria,

If I've understood you correctly and your cat is not getting any insulin then it would seem that she is in remission! That is to say, the diabetes is being controlled with diet alone. Congratulations, you've done a great job!
:RAHCAT

That '8' is a smidge above the typical normal range but way too low to give insulin. And it may continue to drop over time.

As long as your cat is eating an appropriate diet (is she eating low carb wet/canned?) then she may remain in remission. There are no guarantees on that one, but we're keeping fingers and paws crossed for you here!

Excellent stuff!

Elizabeth
 
If and only if she goes over 11.1 (200 mg/dL) would you want to give insulin, and certainly not 2 units.

If you can eyeball it, and she is elevated enough you might test 0.25 units.

Look for infections that might the glucose. Common culprits include dental disease, upper respiratory infection, and bladder infections.
 
Hi

Thanks for the replies.

Our vet said to inject her with 2 units of Cannoinsulin if her BG goes above 8.0. We accidentally missed a dose one evening and the next morning her level was below 6.0 so we havent been giving her the insulin for about a week now. We're still blood testing her morning and evening to monitor her BG levels.
 
Hi Elizabeth

If that's what's happening then Yipee!!

I changed her diet to a wet canned food diet only, I buy her Bozita as I read it's low in carbs and good for diabetic cats. She was on it for about ten days and then her BG dropped from the mid twenties to below 10!
 
Here we consider a cat OTJ (off-the-juice, in remission, not needing insulin for a while), if the BG numbers stay between 2.2-7.2 mmol/L (40-130 mg/dL) with most of those readings below 5.5 mmol/L (100 mg/dL) for a 14 day period.

Since some of those BG numbers you are getting are a little higher, you may want to continue beyond the 2 week trial period to make sure the BG numbers are not creeping back up again.

Let us know how it goes on the OTJ trial. We like to have a party to celebrate those special kitties that go into remission, OTJ.
 
Thanks, it hadn't occurred to me that she could be in remission - I assumed as she's old we would never get her into remission! I'll keep testing to make sure for at least another 2 weeks then.

Thanks so much!
 
Tia_24 said:
Our vet said to inject her with 2 units of Cannoinsulin if her BG goes above 8.0.
We accidentally missed a dose one evening and the next morning her level was below 6.0 so we havent been giving her the insulin for about a week now.
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Hi again, Maria,

OK, as others have said, to be considered 'in remission' she will need to remain at those sort of numbers for at least 2 weeks without insulin; so, as Deb has said this is an 'OTJ' ('off the juice'!) trial. nailbite_smile ;-)

Here, we suggest that no insulin is given below a blood glucose of 11(200) unless/until the caregiver has data of how their cat responds when being given insulin at lower numbers. You are obviously hometesting though (hooray!) and so maybe you do have some of that kind of data...? Do you know what your cat's blood glucose was dropping to in the middle of the insulin cycle?

Also, 2 units is a lot of insulin to give at low numbers. If she does warrant dose of insulin then, as BJM says, you may only want to try a tiny weeny dose, and then monitor her to see what happens.

Well done for switching to low carb wet food. It sounds like it has made a considerable difference to your cat! What is the little lady's name, by the way?

Eliz
 
Sometimes, just the food change (and a little insulin) is enough to kickstart the pancreas into working properly again. It sounds like this may be the case for your cat!
:-D
 
Her name is Amy and she's a pretty tough old girl! We're not sure if she's 19 or 20 but when we found out she had FD we decided that we'd do whatever we could for her! Home testing was a difficult skill to master (and stressful for us all!!) but both my partner and I can test her on our own now and Amy isn't fussed by it at all!

She loves the wet food which always helps and I make sure to mix up all the flavors so she doesn't get bored!

She hasn't had an insulin injection since last Friday morning so I'll continue to monitor her BG as normal in the morning and evening and make sure that it doesn't get too high. I don't know how she responds during the middle of the insulin cycle, our vet told us to test her morning and evening before she ate, make sure that she ate and then give her the injection. We haven't been testing her after we give her the injection as we weren't instructed to do so!! In fact we're probably going against the vets advice by not giving her the insulin, he told us she would need it for the rest of her life!
 
Are you in the UK, Maria?

I think a lot of vets here are under the impression that remission is a rarity (and I've heard of some who don't think it exists at all...). But in fact, if I recall correctly, I'd guess that of the people from the UK who've joined this forum over the past 6 months about half of those cats have gone into remission: So it's definitely not a myth!

The people who hometest their cats' blood glucose are, of course, in the minority; and I think it's highly likely that many cats are trying to go into remission but their caregivers don't know that! Your cat, Amy, is one of the very lucky ones, because she's had really committed caregivers willing to learn about diabetes and give her the care she needs. :-D

What glucose meter are you using, Maria? Is it an Alphatrack, or one made for humans? (The only reason I ask is that the Alphatrack reads slightly lower than 'human' meters).
Edited to add: DUH! Alphatrack reads higher, not lower, as Deb says below (sorry, definitely need more coffee...)

Eliz
 
(The only reason I ask is that the Alphatrack reads slightly lower than 'human' meters).
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Actually, the Alphatrak reads about 30 points higher at the low numbers, 30-40% higher overall.
 
Hi

Yes I'm in the UK and we are using an AlphaTrak monitor. I didn't even think that it could be giving me an incorrect result, I do the control solution test every time I open a new packet of test strips so assumed that everything would be accurate! So if I'm getting readings from the AlphaTrak of 5.9, she could actually be lower than this?
 
Hi Tia,

Your Alphatrak monitor is just fine. It's not giving you an incorrect result, just a different result that we that advise you need to adjust for.

It's simply that most of us here use human glucometers that read lower,about 30-40 percent than an Alphatrak. Since we know you use an Alphatrak, the numbers you get will need to be adjusted in your advisors minds only. There is nothing different you need to do.

Since that meter reads higher than we are used to, we want that fact to jump out at us in every post you do. Any number under an 4.4 (80mg/dL) is hypo (hypoglycemic) territory and needs some additional action on your part. The normal number we look for is 2.7 (50mg/dL).

To help us remember you have an Alphatrak, would you please add some information to your signature for us?

1.go to the upper left of your screen just below the kitty and you will find the words "user control panel". Click on those words
2. a new screen will show up with tabs goiung horizontally. select the Profile tab
3. new screen pops up with some selections along the left hand side. Select Edit Signature
4. a free form text box pops up, just like if you were writing a new topic or adding to your existing post
5. Type in Alphatrak. Highlight this text with your cursor. Go up to the editing bar at the top of the free form text box where it says "Normal" and click on the drop down arrow. Select Large and this will change the font size for that word you highlighted.
6. click submit to save this change.

While you are there, it would be useful for us to know your location. Go back to the profile tab, select Edit Profile this time, go down to the Location field and put UK in that location field and click submit.

Would you be willing to do those two things for us? Thanks.
 
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf
It is very important to note that blood glucose concentrations measured using a whole blood glucose meter calibrated for human blood may measure 30-40% lower in the low end of the range than glucose concentrations measured using a serum chemistry analyser or a plasma-equivalent meter calibrated for feline use.

Therefore, if using a meter calibrated for feline use (eg. AlphaTRAK, Abbott Laboratories, CA, USA), or a serum chemistry analyzer, add approximately 30 mg/dL (1.7 mmol/L) to the target glucose concentrations (see Table 3B). For example, a target > 50 mg/dL (2.8 mmol/L) becomes > 80 mg/dL (4.4 mmo/L) when using a meter calibrated for feline use. Instead of aiming for 50-100mg/dL (2.8-5.6 mmol/L) , aim for 80-130 mg/dL (4.4-7.2 mmol/L [round numbers 4.5-7.0 mmol/L). Meters calibrated for feline use may read higher or lower than the actual value, in contrast to consistently lower readings for meters validated for human blood.
Click to expand...
 
But
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf
does not match the data in the graphs I provided a link to.

The accuracy of the human meter depends a lot upon how the meter actually works. See:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769957/
This page shows how the distribution of glucose in the blood constituents is significantly different between cats and humans.
http://www.alphatrakmeter.com/alphatrak ... cific.html
Some meters measure glucose by only measuring the glucose in the plasma and some by lysing (disrupting the red blood cells) and measuring the total glucose. The human meters than correct the reading and the readout is calibrated for the plasma reading that lab machines. Thus, that is why some human metters work good on cats and some do not,
 
Hi Deb

Thanks so much, I wanted to add a signature but couldn't work out how to do it yesterday so thank you!

I understand now, thanks so everyone who posted info about the different types of meters and reading, thanks BJM as well.

This morning she was 7.4 (although I tested her later than usual as I was running late!) - we're nearly a week without insulin now!
 
That number 7.4 (133.2 mg d/L) is a very good one for no insulin.

To put it in perspective, using an Alphatrak meter as you are, normal non-diabetic test numbers would be 4.4 -8.3 mmol (80-150 mg d/L).

Have all of the numbers in the last days without insulin been in this 4.4-8.3 (80-150) range? If so, you may be on your way to an OTJ trial.

Would you be willing to set up our standard spreadsheet and link it to your signature? You'll want to select the world version and enter the data on the world tab of the spreadsheet. Us backward folks in the US are still using an antiquated measuring system and keep having to translate the numbers. This spreadsheet is a good way to keep track of the numbers, even after your cat goes OTJ.

Spreadsheet instructions here: spreadsheet setup

My foster cat Wink has been OTJ for two months now, but I test at least once a week. I want to catch any rise in the BG numbers quickly and get him back on insulin ASAP if needed.
 
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